Repeal or Repair ObamaCare?

Vanity Fair had an interesting article about Republicans continued failure to repeal and replace ObamaCare. Republicans are awakening to the treacherous reality of rewriting the nation’s health-care policy. The majority of Republicans in Congress acknowledge that the Affordable Care Act may never be completely unwound. First, Republicans dramatically pushed back their timetable for replacing President Obama’s health care law, settling on a strategy for an immediate, partial repeal followed by a multiyear replacement process. Now, CNN reports, Republicans are quietly beginning to add a third “R” word to their political lexicon: repair. The suggestion that Trump is considering saving certain aspects of the Affordable Care Act is a definite shift in the narrative after the Republican party has campaigned on repealing the law in its entirety for years.

With public support for universal health care in the United States at an all-time high and Trump insisting that his inchoate replacement plan will provide “insurance for everyone”, G.O.P. lawmakers are scrambling to craft an Obamacare replacement that won’t rattle insurance markets or tank their chances of re-election.”

Trump has made sweeping promises that nobody will lose coverage under his plan; that people with pre-existing conditions won’t be denied coverage; and that the A.C.A.’s Medicaid expansion won’t be rolled back—all of which are expensive. As the law currently stands, the Affordable Care Act is funded through taxes levied on insurers, medical device companies, high-income households, and employers with expensive health-care plans—all of which are on the chopping block. Republicans are racking their brains to devise a magic bullet, but health care experts are skeptical that any market-based solution exists.

Republicans are also reportedly still searching for a mechanism to prevent people with pre-existing conditions from only buying insurance coverage when they get sick. Obamacare relies on the individual mandate and its accompanying tax penalty, both of which Republicans swore to repeal.

Politico reports that tensions are rising within the G.O.P. as lawmakers struggle to identify an alternative to the mandate that isn’t at conflict with Republican “principles” and wouldn’t result in a spike in the uninsured rate.